12 minute read
Roundtable: Care concerns
Care concerns ® oundtable:
Healthcare providers discuss the curent state of healthcare, from efforts to make healthcare more affordable to engaging the aging population and meeting the demands for specialized cancer care.
Ravi Chari, MD President HCA West Florida
How is HCA helping to keep healthcare a¡ordable and accessible? We know that in the Tampa Bay, we need to meet the consumer on their terms. In this area, we have around 4.8 million people, all of whom are potential customers, and when they start seeking healthcare and making choices, they become consumers. We want to make sure we connect and demonstrate our relevance to our potential customer base through our service oerings and outcomes. To that end, we are leveraging services such as telemedicine to achieve the convenience our patients desire and deserve. We are also working to make sure we have transparency and availability of information.
How is HCA West Florida working to push preventive healthcare? We work with primary care physicians to ensure we can support them. Convenient access to the hospital test results involving their patients is one way we ensure that they have essential information to help physicians push preventative healthcare. We also use our data systems to help identify issues to intervene at an earlier stage.
How are you avoiding provider burnout? We asked 600 of our caregivers to come up with a common purpose to explain why they are in healthcare: “We make a dierence by providing compassionate care to those we are privileged to serve.” I want our over 25,000 people who work in our hospitals to know we make a dierence by focusing on patient safety, welcoming all with hospitality, empathizing with our patients and families, and ensuring e©cient, cost-eective care.
Jeff Johnson State Director AARP Brad Prechtl CEO Florida Cancer Specialists
How have you seen the community become more engaged over the last year with the aging population? Formally, we continue to work with organizations like the Foundation for a Healthy St. Petersburg on ways they can engage the aging population. Informally, we have also seen an uptick in interest in creating products and services that specifically serve older people. At the consumer electronics show in Las Vegas last year, there was a huge focus on developing products that help care for the aging population, which is remarkable. This is an opportunity that continues to grow.
One of the biggest barriers for business is also the biggest barrier for people living here and trying to get around, which is transport. Aordable housing is another issue business leaders will talk about. The third issue is social connection. There is a friendliness in the Tampa Bay market that is not seen everywhere, and this is certainly one of the things that attracts people to move to the area. But as a state, we leave a lot of human capital on the table by neglecting to engage those older populations that move to the area.
What makes the Tampa Bay region a unique market for AARP? When AARP was founded in 1958, our founder had a foothold in Downtown St Pete, in a hospitality house. A lot of the flagship projects we have launched have been based out of that location, including mail-order pharmacy, lifelong learning and federal advocacy. This market went through a phase where people thought of it as “God’s Waiting Room,” but now it is very dierent for people across all ages. How is the company meeting the demand for specialized cancer care in the region? We have nearly 240 physicians throughout the state. At the end of 2018, we were at about 220 physicians, so we continue to add physicians to take into account the growth of Tampa Bay and throughout the state. A lot of that is driven by population growth and population aging, as cancer predominantly aects an older population. About 70% of our patients have either Medicare or Medicaid, and so we are constantly looking at how long it takes patients to see a physician.Typically, our patients can see a physician within 72 hours. That is a tremendous benefit to patients.
How is Florida Cancer Specialists working to provide more a¡ordable healthcare to its patient base? Many of us don’t know what we are going to end up paying for services until we have already received the care. All medical oncologists use the same FDA-approved drugs, whether the care is provided in a hospital care setting, an academic medical center or community based like Florida Cancer Specialists. What the government pays for those same services in a hospital outpatient setting or an academic medical center is higher than what we get paid.
If the patient has a copay or deductible to meet, they are going to pay more for the same services in a hospital outpatient setting or an academic medical center versus a community-based center like ours. A lot of our patients have fixed incomes, so a community setting is going to be better for the patient. They can get the same treatment while they are close to home and can sleep in their own beds.
( ) that allowed authorities to regulate CBD and hemp use. “Prior to these rules being adopted and taking effect, we didn’t have regulatory authority,” Cannabis Director at Florida’s Department of Agriculture Holly Bell told The News Service. “Now we do, and we have that up and going so that we can make sure consumers are protected.”
This has given license to the rise of more and more dispensaries in Tampa but also more and more legal challenges to the legislation. Some see the legalization as not going far enough, and want to petition for recreational marijuana to be legalized. The Supreme Court has to sign off on the proposal before it goes to voters but is reportedly “skeptical” of the ability to buy and grow marijuana without a medical purpose. The vote may be delayed for the next few years, as pro-marijuana group Make It Legal revealed it wants to shift focus to gain ballot entry in 2022 instead.
Preventative healthcare Preventive healthcare is recognized widely as something that can help save medical funding but very few places have gotten the model right. Florida’s primary care physicians saw an average of 1,376 patients in 2018, a 0.218% decrease from the previous year. Patients seen by dentists were also down 3.23% to an average of 1,735 patients per year and for other primary care providers in Florida there was a dip of 10.5% to an average of 1,139 patients per year. This all suggests that preventive healthcare is declining across the state.
One of the initiatives rolled out to encourage preventive healthcare is mobile mammography trucks. AdventHealth in December purchased the mobile mammography assets that previously belonged to Tampa Bay Mobile Mammography. The sale includes purchasing three specialty buses equipped with Hologic 3D mammography systems with technology capable of scanning 150 people per day.
And while hepatitis A cases were reported at their highest level in Hernando, Pinellas and Pasco counties in June, levels in Hillsborough County dropped drastically in the same month. In the first half of 2019, Hillsborough County reported 103 cases of hepatitis A, averaging about four new cases a week, but in the first three weeks of June, the county only added five new cases. Florida Department of Health epidemiologist Mike Wiese attributed the drop to a ramp up in outreach events where vaccinations and education on the spread of the disease were provided. In January 2019, Hillsborough County health workers gave 229 adult vaccines, which increased exponentially in May to 762 vaccines.
3D modeling is just one of the many innovations healthcare technology has been able to capitalize on.
Technology House Bill 23, passed on 1 July outlines the standards of practice for telehealth providers, registration of out-ofstate providers, venue requirements and exemptions, which solidifies the position and regulation of telehealth in Florida’s healthcare system. In a growing patient base such as Tampa with a shortage of qualified medical practitioners, telehealth has often been seen as the solution to make it more efficient to meet routine medical needs.
In perhaps the most glaring example of convenience medicine in Tampa, Tampa General Hospital in October partnered with Florida-based technology company OnMed to pilot the company’s telemedicine station, featuring thermal imaging, ultraviolet sanitization and facial recognition to operate as self-contained, unstaffed exam rooms. The unit enables TGH staff members to have video consults with healthcare providers and features a built-in automated prescription drug dispensary, increasing efficiency and cutting wait times.
But telemedicine is not the only way technology is disrupting medicine. Bridge Connector, based in West Palm Gardens, is a health tech company that creates a network to connect data systems quickly and cost efficiently. It attracted $5 million in funding from Tampa Bay Lightning owner Jeff Vinik. And Dr. Abilash Haridas, a surgeon at St. Joseph’s Children’s Hospital in Tampa is using virtual reality to take MRIs and CT scans to create a 3D model of the brain that is then used for surgery.
Research Medical knowledge is said to double every 73 days in Tampa, making it a well-established medical research hub. Innovation abounds in the region, across prestigious institutes such as the Morsani College of Medicine at USF, Nova Southeastern University’s Tampa Bay Regional Campus, the Medical Prep Institute of Tampa Bay and the Ultimate Medical Academy.
February 2020 marked the opening ceremony of the new USF Health Morsani College of Medicine and Heart Institute, a “preeminent research university” according to Florida’s Board of Governors. USF is only the third university in the state to receive state funding. The $3 billion development is located on Water Street and with the potential to accommodate 23,000 residents, workers and visitors, its economic impact is estimated at $73 million, meaning every dollar of federal grant money for research will pump $2.60 into the economy. Classes began in January,
Richard Atkin CEO – Greenway Health
There are many technology trends. Something that we discuss internally is that recently technology is not advancing at the same speed that it does in other areas where it is already embedded in our life, like with smartphones, which are only 10 years old. Within healthcare, there are still very ine©cient processes in areas like patient care, payment processing and regulations. Technology has the opportunity to dramatically improve the way we all interact with the healthcare system and the way providers who work within healthcare can work to benefit the patient. The latest technology, like video and voice to text and various other things, have really exploded in other areas of our life, so how do we use those to the greatest eect. Our mission is not just providing technology, but enabling patients to get better and more access to care.
Florida’s primary care doctors saw 1,376 patients on average in 2018.
heart institute researchers arrived in February and the Taneja College of Pharmacy is slated to begin work in the fall.
Cancer is another major illness being studied in Tampa. Tampa scientists Michael and Patricia Lawman developed a cancer vaccine using gene and cell therapy research. The ImmuneFx works by luring cancerous tumor cells out of hiding so they can be identified more easily by the body and can more easily be combated by means other than radiotherapy. Their company Morphogenesis carried out extensive lab work to develop the vaccine. The results showed a 77% reduction in tumors, attracting $27 million in investor funding for research. Morphogenesis is now closing in on another round of nearly $45 million. The research is vitally important but there is a problem. Many people still don’t have access, according to innovators like Erik Maltais, co-founder and CEO of IMMERTEC. “Five billion people on the planet don’t have access to safe and affordable surgery. This is going to lead to 17 million deaths annually, which is 20 times more of a problem than AIDS and tuberculosis combined. Sixty percent of Americans do not have access to trauma level 1 and 2 care. There is a situation happening in the world that involves centralized specializations. This means there are great centers of excellence like Johns Hopkins, Harvard and other excellent universities and healthcare systems, where they specialize in one dysfunction or disorder. These healthcare centers bring the best minds together, and they push each other to solve a specific problem. However, the issue is that the actual people who suffer from these problems are not usually located in these areas where the healthcare centers are. Instead they are located throughout the country and the world.”
But it is not all rosy in Tampa’s medical research world. According to a study last summer by TrialScout, Tampa lags behind similar cities such as Columbus, Ohio, St Louis and Raleigh, North Carolina in clinical research. Moffitt Cancer Center produces most of Tampa’s clinical research, accounting for 27% in 2018, University of South Florida Health produced 12.8%, Florida Cancer Specialists and Research Institute produced 6.9%, BayCare Health Systems produced 6% and Tampa General Hospital produced 5.8%.
Looking ahead The Tampa Bay region is working hard to cement its position as a medical hub, not only in the United States but globally. Already, the area has attracted the attention of multinational companies and prestigious scientists and researchers and continues to innovate.
But despite its strength in medical research, Tampa continues to take a retroactive approach to healthcare, rather than preventive and this unnecessarily burdens healthcare systems. With a prolonged COVID-19 outbreak, the system will be streteched to its limits. In early April, hospitals had stopped delivering some non-essetial services and were calling for more funds to fight the pandemic.
Education:
Workforce preparation and getting more high-school students into higher education, or on a track that will deliver the skilled labor local companies require, remain key goals for the region’s education sector. The state budget itself tells the tale: the leading focus for Gov. Ron DeSantis in the budget he tabled targeted improvements in all areas of the sector.
